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Guy Harling


Peer-reviewed articles   |    Other publications   |    Presentations

Peer-Reviewed Articles

  1. Barnhart DA, Harling G, Muya A, Ortblad KF, Mashasi I, Dambach P, Ulenga N, Mboggo E, Oldenburg CE, Bärnighausen TW, Spiegelman D. Structural, interpersonal, psychosocial, and behavioral risk factors for HIV acquisition among female bar workers in Dar es Salaam, Tanzania. AIDS Care. Epub ahead of print.
    [PubMed]   [Journal (gated)]    [Self-archive (accepted version)]  
  2. Yang Y, McKhann A, Chen S, Harling G, Onnela J-P. Efficient vaccination strategies for epidemic control using network information. Epidemics. Epub ahead of print.
    [PubMed]   [Journal (open)]    [arXiv preprint]   
  3. Harling G, Chanda MM, Ortblad KF, Mwale M, Chongo S, Kanchele C, Kamungoma N, Barresi LG, Bärnighausen TW, Oldenburg CE. The influence of interviewers on survey responses by female sex workers in Zambia. BMC Medical Research Methodology. 2019; 19: 60.
    [PubMed]   [Journal (open)]
  4. Harling G, Muya A, Ortblad KF, Mashasi I, Dambach P, Ulenga N, Barnhart D, Mboggo E, Oldenburg CE, Bärnighausen TW, Spiegelman D. HIV risk and Pre-exposure Prophylaxis interest among female bar workers in Dar es Salaam: a cross-sectional survey. BMJ Open. 2019; 9: e023272.
    [PubMed]   [Journal (open)]
  5. Ortblad KF, Musoke DK, Ngabirano T, Nakitend A, Harling G, Haberer JE, McConnell M, Salomon JA, Oldenburg CE, Bärnighausen TW. The effect of HIV self-testing delivery models on female sex workers' sexual behaviors: a randomized controlled trial in urban Uganda. AIDS & Behavior. Epub ahead of print.
    [PubMed]   [Journal (open)]
  6. A secondary analysis of the Kampala-based sister trial to ZEST (see below), also focused on HIV self-tests. Here there was no association between study arm (direct HIV self-test, facility-collection of HIV self-test, standard of care) and sexual behaivour. These findings reinforce the safety of HIV self-tests, i.e. no behavioural compensation, while highlighting context-specificity of impact.

  7. Harling G, Payne CF, Davies JI, Gomez-Olive FX, Kahn K, Manderson LK, Mateen FJ, Tollman SM, Witham MD. Impairment in activities of daily living, care receipt and unmet need in an older rural South African population: findings from the HAALSI study. Journal of Aging and Health. Epub ahead of print.
    [PubMed]   [Journal (open)]
  8. We analysed the baseline round of HAALSI and found that while older people unsurprisingly had greater levels of impairment and need, partially or entirely unmet need was more common in younger respondents (e.g. 40-60 year olds) and women. Our conclusion: judge people's needs by what they say/display, not by your expectations.

  9. Manne-Goehler J, Siedner M, Montana L, Harling G, Geldsetzer P, Rohr J, Gomez-Olive FX, Goehler A, Wade A, Gaziano T, Kahn K, Davies JI, Tollman S, Bärnighausen TW, Tollman S. Hypertension and diabetes control along the HIV care cascade in rural South Africa. Journal of the International AIDS Society. 2019; 22(3): e25213. [PubMed]   [Journal (open)]
  10. Again in HAALSI, we explored whether being under care for HIV improved control of other chronic health conditions. Having well-controlled HIV (undetectable viral load) was associated with having a hypertension diagnosis, being on treatment and having lower blood pressure (among those with need); there was no such associations for type-II diabetes, although undetectable VL with lower mean glucose among the diagnosed. We conclude that HIV treatment may have the potential to act as a partial gateway to cardiometabolic disease care.

  11. Manne-Goehler J, Rohr J, Montana L, Siedner M, Harling G, Gomez-Olive FX, Geldsetzer P, Wagner R, Weisner L, Kahn K, Tollman S, Bärnighausen TW. ART denial: results of a home-based study to validate self-reported antiretroviral use in rural South Africa. AIDS & Behavior. Epub ahead of print. [PubMed]   [Journal (open)]
  12. In the HAALSI cohort (aged 40+) we show that among respondents who had detectable antiretrovirals in their blood (i.e. are actively being treated for HIV), over a third denied currently being on treatment. We discuss possible reasons for this discrepancy, including ongoing HIV-related stigma and misunderstanding of healthcare.

  13. Ortblad KF, Bärnighausen TW, Chimbindi N, Masters SH, Salomon J, Harling G. Predictors of circumcision incidence in a traditionally non-circumcising South African population-based cohort. PLoS ONE. 13(12): e0209172. [PubMed]   [Journal (open)]
  14. We showed that in the period 2009-2014 circumcision rates among adults in KZN rose, but remainded a minority of the population, even among the core target population of young men. We highlighted that perceived need and access may be a key barrier: circumcision rates were higher for those who knew their HIV serostatus and those living close to a clinic.

  15. Ortblad KF, Harling G, Chimbindi N, Tanser F, Salomon J, Bärnighausen TW. Does circumcision incidence lead to risk compensation? Evidence from a population cohort in KwaZulu-Natal, South Africa. Journal of Acquired Immune Deficiency Syndromes. Epub ahead of print. [PubMed]   [Journal (open)]
  16. We evaluated whether men's self-reported sexual behaviours changed after being circumcised as adults in KZN, South Africa. We found no evidence for circumcision increasing or decreasing risky sexual behaviours, contrary to fears that circumcision would lead to more risk-taking ("risk compenstation")

  17. Harling G, Gumede D, Shahmanesh M, Pillay D, Bärnighausen TW, Tanser F. Sources of social support and sexual behaviour advice for young adults in rural South Africa. BMJ Global Health. 2018; 3: e000955.
    [PubMed]   [Journal (open)]
  18. We asked 18-35 year olds in eastern KZN about their social support networks. We found that while older relatives provide most financial, physical and general information sexual advice largely comes from friends and same-generation relatives. We discuss how to potentially use both sets of social connections to provide key sexual health messages.

  19. Coltart CEM, Hoppe A, Parker M, Dawson L, Amon JJ, Simwinga M, Geller G, Henderson G, Laeyendecker O, Tucker JD, Eba P, Novitsky V, Vandamme A-M, Seeley J, Dallabetta G, Harling G, Grabowski MK, Godfrey-Faussett P, Fraser C, Cohen MS, Pillay D. Ethical Considerations in HIV Phylogenetic Research. Lancet HIV, 2018; 5(11): PE656-E666.
    [PubMed]   [Journal (open)]  
  20. The output of a PANGEA meeting in 2018 on ethics and phylogenetics, this paper aims to outline the wide range of implications arising from the use of HIV phylogenetic analysis. Key issues raised include protecting those providing samples (and linked others), balancing such risks against potential benefits, and communicating the process of genotyping and its possible impacts to all stakeholders.

  21. Haber N, Harling G, Cohen J, Mutavedzi T, Tanser F, Gareta D, Herbst K, Pillay D, Bärnighausen TW, Fink G. List randomization method for eliciting HIV status and sexual behaviors in rural KwaZulu-Natal, South Africa: a randomized experiment. BMC Medical Research Methodology, 2018; 18: 46.
    [PubMed]   [Journal (open)]
  22. We tested the use of List Randomization (LR), a method for learning about sensitive behaviours without requiring respondents to answer directly, when asking respondents about HIV status and HIV testing history. Comparing results from this method to known past history, we found LR performed poorly, possibly due to under-training of field interviewers.

  23. Oldenburg CE, Bor J, Harling G, Tanser F, Mutevedzi T, Shahmanesh M, Seage GR, De Gruttola V, Mimiaga MJ, Mayer KH, Pillay D, Bärnighausen TW. Impact of early antiretroviral therapy eligibility on HIV acquisition: Household-level evidence from rural South Africa. AIDS, 2018. 32(5):635-643.
    [PubMed]   [Journal (open)]
  24. We used a quasi-randomizaed regression discontinuity design, based on whether individuals were eligible for immediate ART (CD4 count < 200 at date of HIV diagnosis). We showed that the household members of those receiving immediate ART had 47% lower hazard of HIV acquisision. This suggests substantial spillover benefits from early ART initiation.

  25. Oldenburg CE, Chanda MM, Ortblad KF, Mwale M, Chongo S, Kamugoma N, Kanchele C, Fullem A, Baresi LG, Harling G, Bärnighausen TW. Effect of HIV self-testing on the number of partners among female sex workers in Zambia: A randomized controlled trial. AIDS, 2018. 32(5):645-652.
    [PubMed]   [Journal (open)]
  26. A secondary analysis of the ZEST trial data, showing HIV self-test arm participants reduced their number of nightly sexual partners (both commerical and non-commercial) by more than those in the control arm. This suggests that self-testing may have positive spillover benefits, over and above learning HIV status (since testing rates did not differ by arm).

  27. Harling G, Perkins JM, Gómez-Olivé FX, Morris KA, Wagner RG, Montana L, Kabudula C, Bärnighausen TW, Kahn K, Berkman L. Interviewer-driven variability in social network reporting: results from Health and Aging in Africa: a Longitudinal Study of an INDEPTH community (HAALSI) in South Africa. Field Methods, 2018. 30(2): 140–154.
    [PubMed]   [Journal (gated)]    [Self-archive (accepted version)]   [ PubMed Central (from 1 May 2019)]
  28. Another HAALSI analysis, focused on social network data from the baseline wave of this cohort. We show that even in a one-round survey, the number of important contacts named by respondents fell steadily across the interview period, rebounding only after intensive interviewer retraining. Takeway: Fieldworkers are vital to data collection, they need lots of support and some monitoring.

  29. Harling G, Morris KA, Manderson L, Perkins JM, Berkman LF. Age and gender differences in social network composition and social support among older rural South Africans: findings from the HAALSI study. The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 2018. Epub ahead of print.
    [PubMed]   [Journal (open)]   [SSRN preprint]   [Harvard HCPDS Working Paper 17(1) (pdf)]
  30. An analysis of how core social network size and composition varied by age and gender amongst older rural South Africans in the HAALSI study. Our key finding was that older women had smaller networks, largely due to very high levels of widowhood and thus the absence of spousal support. This is in contrast to previous findings in higher-income settings, where men see greater reductions in social support as they age.

  31. Harling G, Onnela J-P. The impact of degree truncation via fixed choice designs on the spread of contagious processes on networks. Network Science, 2018. 6(1):34-53.
    [PubMed]   [Journal (open)]   [arXiv preprint]  
  32. We looked at how limiting the amount of data one collects on a social network affects predictions of how epidemics will spread across said networks. Using simulation methods we showed that prediction accuracy fell, with an initial small loss of fidetly followed by a rapid drop-off as more network data was lost. The point of sudden change differed depending on the structure of the network being studied.

  33. Chanda MM, Ortblad KF, Mwale M, Chongo S, Kanchele C, Kamungoma N, Fullem A, Dunn C, Barresi LG, Harling G, Bärnighausen TW, Oldenburg CE. HIV self-testing among female sex workers in Zambia: A randomized controlled trial. PLoS Medicine, 2017. 14(11):e1002442.
    [PubMed]   [Journal (open)]
  34. Primary results from the ZEST trial, showing that HIV self-testing was feasible and acceptable for FSW. The high level of HIV testing in the control arm meant that significant improvements in HIV test uptake in the self-testing arms were not seen.

  35. Saffier IP, Kawa H, Harling G. A scoping review of prevalence, incidence and risk factors for HIV infection amongst young people in Brazil. BMC Infecious Diseases, 2017. 17:675.
    [PubMed]   [Journal (open)]
  36. A systematic review of the literature on HIV prevalence and risk factors associated with HIV positivity among 10-25 year old Brazilians. Highlights the shortage of systematic data collection and geographic and risk-group gaps.

  37. Harling G, Gumede D, Mutevedzi T, McGrath N, Seeley J, Pillay D, Bärnighausen TW, Herbst K. The impact of self-interviews on response patterns for sensitive topics: a randomized trial of electronic delivery methods for a sexual behaviour questionnaire in rural South Africa. BMC Medical Research Methodology, 2017. 17:125.
    [PubMed]   [Journal (open)]   [SSRN preprint]
  38. A detailed description of a four-arm randomized trial showing the feasibility and acceptability of using electronic tablets, and respondent-led data entry, for interviews in rural South Africa. Led to the implementation of electronic data collection in the AHRI health and demographic surveillance programme.

  39. Chanda MM, Ortblad KF, Mwale M, Chongo S, Kanchele C, Kamungoma N, Barresi LG,Harling G, Bärnighausen TW, Oldenburg CE. Contraceptive use and unplanned pregnancy among female sex workers in Zambia. Contraception, 2017. 96(3): 196-202.
    [PubMed]   [Journal (open)]
  40. A description of the very high levels of unplanned pregnancy among female sex workers in Zambian border towns (ZEST study). Highlights the need for contraception support of various kinds.

  41. Harling G, Lima Neto AS, Sousa GS, Machado MMT, Castro MC. Determinants of Tuberculosis transmission and treatment abandonment in Fortaleza, Brazil. BMC Public Health, 2017. 17:508.
    [PubMed]   [Journal (open)]
  42. An analysis of the spatial distribution and risk factors for TB incidence and incomplete treatment in the 5th largest city in Brazil. Incidence rates failed to drop as treatment success rates and DOT coverage fell.

  43. Manne-Goehler J, Montana L, Gómez-Olivé FX, Rohr J, Harling G, Wagner R, Wade A, Kabudula CW, Tollman S, Berkman LF, Bärnighausen TW, Gaziano TA. The ART advantage: healthcare utilization for diabetes and hypertension in rural South Africa. Journal of Acquired Immune Deficiency Syndromes, 2017. 75(5): 561-567.
    [PubMed]   [Journal (gated)]   [PubMed Central (open)]
  44. A paper from the HAALSI cohort at the Agincourt study site in rural Mpumalanga, South Africa. We highlight that amongst older adults, being on ART is associated with improved control of diabetes and hypertension relative to those HIV-negative or HIV-positive but not on ART. This suggests accessing ART may be protective for other health conditions.

  45. Harling G, Moyo S, McGovern ME, Mabaso M, Marra G, Bärnighausen TW, Rehle T. National South African HIV prevalence estimates robust despite substantial test non-participation. South African Medical Journal, 2017. 107(7): 590-594.
    [Journal (open)]  
  46. We reanalysed the 2012 South African national HIV survey, for which many people had refused to test for HIV. We showed that even allowing for non-random missingness due to unobserved factors (i.e. missingness not at random), the original HIV estimates were reliable. (Technically, the paper used a Selection model that leveraged random assignment of interviewers, who then affected willingness to test, as an instrument.)

  47. Oldenburg CE, Ortblad KF, Chanda M, Mwanda K, Nicodemus W, Sikaundi R, Fullem A, Baresi LG, Harling G, Bärnighausen TW. Zambian Peer Educators for HIV Self-Testing (ZEST) study: rationale and design of a cluster randomised trial of HIV self-testing among female sex workers in Zambia. BMJ Open, 2017. 7: e014780
    [PubMed]   [Journal (open)]
  48. The protocol paper for a three-arm randomized controlled trial of different methods for providing Zambian FSW with HIV self-tests.

  49. De Neve J-W, Harling G. Offspring schooling associated with increased parental survival in rural KwaZulu-Natal, South Africa. Social Science & Medicine, 2017. 176: 149-157
    [PubMed]   [Journal (open)]
  50. Using a dataset of almost 18,000 adults followed for up to 13 years, we showed that having better-educated children was associated with lower mortality for parents.

  51. Harling G, Wang R, Onnela J-P, De Gruttola V. Leveraging contact network structure in the design of cluster randomized trials. Clinical Trials, 2016. Epub ahead of print.
    [PubMed]   [PubMed Central (open)]   [Journal (open)]   [arXiv preprint]   [Harvard University Biostatistics Working Paper]
  52. We describe a new approach to designing CRTs which starts with those clusters most connected to the rest of the world. Using simulations we show that this significantly increases the speed at which epidemics can be controlled, with only a small drop in power to detect differences across study arms.

  53. Valeri L, Patterson-Lomba O, Gurmu Y, Ablorh A, Bobb J, Townes W, Harling G. Predicting subnational Ebola virus disease epidemic dynamics from sociodemographic indicators. PLoS ONE, 2016; 11(10): e0163544.
    [PubMed]   [Journal (open)]
  54. A collaborative student and postdoc project that emerged from an Ebola Hackathon in late 2014. A combination of epidemic curve-fitting work and Demographic and Health Survey data, used to show how predictions of epidemic spread might be possible using on-the-shelf data.

  55. Oldenburg CE, Bärnighausen T, Tanser F, Iwuji CC, De Gruttola V, Seage GR, Mimiaga MJ, Mayer KH, Pillay D, Harling G. Antiretroviral therapy to prevent HIV acquisition in serodiscordant couples in a hyperendemic community in rural South Africa. Clinical Infectious Diseases, 2016; 63(4): 548-554.
    [PubMed]   [Journal (open)]
  56. An analysis of HIV incidence amongst cohabiting couples in the Africa Centre for Population Health (now AHRI) Demographic Surveillance Area. Key finding: ART is associated with a 77% reduction in hazard of HIV infection, lower than figures from carefully controlled trials.

  57. Harling G, Bärnighausen T. The role of partners’ educational attainment in the association between HIV and education amongst women in seven sub-Saharan African countries. Journal of the International AIDS Society, 2016; 19: 20038.
    [PubMed]   [Journal (open)]
  58. An analysis of 14 Demographic and Health Surveys in 7 countries, looking at how partner's education is associated with womens' HIV status. Finds that even after adjusting for own education, having a partner with much higher or lower education is associated with increased likelihood of being HIV-positive.

  59. Herbst K, Law M, Geldsetzer P, Tanser F, Harling G, Bärnighausen T. Innovations in data collection in health and demographic surveillance systems to establish causal impacts of health policies to improve the HIV treatment cascade. Current Opinion in HIV and AIDS, 2015; 10(6): 483-494.
    [PubMed]   [Journal (open)]
  60. Provides an overview of how novel approaches to data collection in routine surveillance settings can improve data and thus help us better understand how policy affects HIV treatment outcomes. Topics include data collection using: biomarkers; spatial data; social network information; migration events; electronic questionniare methods and mobile phone records. Also discusses linking survey data to administrative records on health, education and welfare services.

  61. Harling G, Tanser F, Mutevedzi T, Bärnighausen T. Assessing the validity of respondents’ reports of their partners’ ages in a rural South African population-based cohort. BMJ Open, 2015. e005638.
    [PubMed]   [Journal (open)]
  62. An analysis of how accurately individuals living in the Africa Centre for Health and Population Studies' Demographic Surveillance Area were able to estimate their partners' age. Conducted by comparing each persons' report of their relationship age-disparity to the age self-report made by their partners. Finds individuals generally are quite close to correct, but with a tendency to lump their relationship age-disparity towards round numbers (5, 10, 15 etc). Shows that accuracy of partner age reports in South Africa is markedly higher than seen elsewhere in Africa.

  63. Harling G, Newell ML, Tanser F, Bärnighausen T. Partner age-disparity and HIV incidence risk for older women in rural South Africa. AIDS & Behavior, 2015. Epub ahead of print.
    [PubMed]   [Journal (gated)] [PubMed Central (open)]
  64. A partner paper to our earlier analysis of women aged under 30, this paper analyses HIV infection risk for women aged 30-57, based on their most recent relationship's age-disparity. Finds that middle-aged women with same-aged partners were at greatest risk of infection, with risk for a woman with a same-aged partner being double that of one with a partner 10 years older than her.

  65. Harling G, Newell ML, Tanser F, Subramanian SV, Kawachi I, Bärnighausen T. Do age-disparate relationships drive HIV incidence in young women? Evidence from a population cohort in rural KwaZulu-Natal, South Africa. Journal of Acquired Immune Deficiency Syndromes, 2014. 66(4): 443-451.
    [PubMed]   [Journal (gated)] [PubMed Central (open)]
  66. Provides a longitudinal analysis of the association between the age-difference between 15-29 year old women and their most recent partner, and subsequent HIV infection. In a study population from rural KwaZulu-Natal, South Africa, finds that while age-disparities were moderate (mean of 4 years difference), there was no association between partner age-disparity and HIV.

  67. Harling G, Subramanian SV, Bärnighausen T, Kawachi I. Income inequality and sexually transmitted infections in the United States: Who bears the burden? Social Science & Medicine, 2014. 102: 174-182.
    [PubMed]   [Journal (gated)] [ Postprint (open; pdf)]
  68. Provides a method for conceptualizing and empirically measuring the three types of effects believed to connect income inequality to health - absolute deprivation (Income), relative deprivation (Yitzhaki index) and structural inequality (Gini coefficient). Highlights how relative deprivation can be conceptualized as the interaction of the other two. Implements the method to examine bacterial STI outcomes in the Add Health study, showing that all but the absolute deprivation effect are confounded by individual race/ethnicity.

  69. Harling G, Castro MC. A spatial analysis of social and economic determinants of tuberculosis in Brazil. Health & Place, 2013; 25C: 56-67.
    [PubMed]   [Journal (gated)] [ Postprint (open; pdf)]
  70. Provides a descriptive analysis of tuberculosis at the municipality level in Brazil, followed by an analysis of poverty, population density, urbanicity and race as determinants of TB case rates that shows the importance of allowing for spatial autocorrelation.

  71. Oldenburg CE, Bärnighausen T, Harling G, Mimiaga MJ, Mayer KH. Adherence to post-exposure prophylaxis for non-forcible sexual exposure to HIV: a systematic review and meta-analysis. AIDS & Behavior, 2014; 18(2): 217-25.
    [PubMed]   [Journal (gated)] [PubMed Central (open)]
  72. Reviewing the existing literature on PEP for non-forcible sexual exposure to HIV, the authors find wide variability in methods and resulting levels of adherence. Adherence was notably higher than amongst those experiencing sexual assault. Applicability to pre-exposure prophylaxis is discussed.

  73. Harling G, Subramanian SV, Bärnighausen T, Kawachi I. Socioeconomic disparities in sexually transmitted infections among young adults in the United States: examining the interaction between income and race/ethnicity. Sexually Transmitted Diseases, 2013. 40(7): 575-581.
    [PubMed]   [Journal (gated)] [PubMed Central (open)]
  74. An analysis of socioeconomic gradients of bacterial STI risk in the Add Health cohort up to young adulthood. Finds gradients in risk within racial/ethnic groups, with those for non-White groups being steeper. Also reinforces the finding of large gaps between racial/ethnic groups, even within income strata.

  75. Beck EJ, Avila C, Gerbase S, Harling G, DeLay P. Counting the cost of not costing HIV health facilities accurately: pay now, or pay more later. Pharmacoeconomics, 2012. 30(10): 887-902.
    [PubMed]   [Journal (gated?)]
  76. An overview of the potential risks of relying on cost information from non-local sources in planning national responses to the HIV epidemic. Provides an outline of the data currently available, and how one might go about improving data collection methods in the future.

  77. Beck EJ, Mandalia S, Harling G, Santas XM, Mosure D, DeLay PR. Protecting HIV-information in countries scaling up HIV services. Journal of the International AIDS Society, 2011. 14(1): 6.
    [PubMed]   [Journal (open)] [PubMed Central (open)]
  78. A baseline assessment of national policies in place to protect HIV-related information. Only around a quarter of 77 responding countries reported having guidelines in place; overall protection levels were low.

  79. Müller AD, Jaspan HB, Myer L, Lewis A, Harling G, Bekker LG, Orrell C. Standard measures are inadequate to monitor pediatric adherence in a resource-limited setting. AIDS & Behavior, 2011; 15(2):422-431. [PubMed]   [Journal (open)]
  80. A comparison of various adherence measures to pediatric ART in a primary care facility near Cape Town. None of the alternatives correlated highly with a cap-release based electronic measurement system, but this latter proved far more expensive.

  81. Harling G, Msisha W, Subramanian SV. No association between HIV and intimate partner violence among women in 10 developing countries. PLoS One, 2010. 5(12): e14257.
    [PubMed]   [Journal (open)]
  82. An analysis of the association between history of intimate partner violence and HIV prevalence among women in the 10 Demographic and Health Surveys collecting both sets of data. We found no statistically significant association for each of three measures of violence (physical or sexual, sexual only, both physical and sexual) in any of the surveys.

  83. Beck EJ, Harling G, Gerbase S, DeLay P. The cost of treatment and care for people living with HIV infection: implications of published studies, 1999-2008. Current Opinion in HIV and AIDS, 2010. 5(3): 215-224.
    [PubMed]   [Journal website (gated?)]
  84. A comprehensive review of the literature on costs for HIV treatment and care over the past decade. This study updates and complements an earlier study covering the literature up to 1999.

  85. Harling G, Ehrlich R, Myer L. The social epidemiology of tuberculosis in South Africa: a multilevel analysis. Social Science and Medicine, 2008; 66(2); 492-505.
    [PubMed]   [Journal (gated)] [ Postprint (open; pdf)]
  86. An analysis of the 1998 South African Demographic and Health Survey for social determinants associated with having been diagnosed with tuberculosis. Finds associations with low income and high income inequality, in addition to standard demographic, behavioural and environmental risk factors.

  87. Harling G, Wood R. The evolving cost of HIV in South Africa: changes in healthcare cost with duration on ART for public sector patients. Journal of Acquired Immune Deficiency Syndromes, 2007; 45: 348–354.
    [PubMed]   [Journal (open)]
  88. An analysis of the changes in cost of care for individuals as they begin and maintain antiretroviral treatment. Costs were high immediately prior to, and during the first year of, treatment. Subsequently they declined, largely due to reduced hospital costs.

  89. Harling G, Bekker L-G, Wood R. The cost of an ART clinic. South African Medical Journal, 2007; 97(8): 593-596.
    [PubMed]   [Journal (open; pdf)]
  90. A costing of the construction and maintenance of a stand-alone antiretroviral treatment clinic in a peri-urban setting near Cape Town. More than 60% of total costs were for staff.

  91. Harling G, Orrell C, Wood R. Healthcare utilization of patients accessing an African national antiretroviral treatment program. BMC Health Services Research, 2007; 7: 80.
    [PubMed]   [Journal (open)]
  92. An assessment of how clinic and hospital care changed with time on antiretroviral therapy (ART). AIDS-related opportunistic infections were identified as the greatest driver of utilization, although this subsided after the first year on ART.

  93. Orrell C, Harling G, Lawn S, Kaplan R, McNally M, Bekker L-G, Wood R. Conservation of first line antiretroviral treatment regimen where therapeutic options are limited. Antiviral Therapy, 2007; 12: 83-88.
    [PubMed]   [ Journal (open; pdf)]
  94. An analysis of the causes of switching from first- to second-line antiretroviral therapy in a peri-urban Cape Town cohort. Overall switching was rare, and mainly caused by virological failure or toxicity.

  95. Lawn SD, Myer L, Harling G, Orrell C, Bekker L-G, Wood R. Determinants of mortality and nondeath losses from an antiretroviral treatment service in South Africa: implications for programme evaluation. Clinical Infectious Diseases, 2006; 43: 770-776.
    [PubMed]   [Journal (open)]
  96. An analysis of loss to follow-up (LTFU) and death in a peri-urban Cape Town ART cohort. While LTFU was low, as was late mortality, deaths immediately prior and subsequent to treatment initiation highlighted the need to begin treatment sooner.

  97. Harling G, Wood R, Beck EJ. Efficiency of Interventions in HIV Infection, 1994-2004. Disease Management & Health Outcomes, 2005; 13(6): 371-394.
    [Journal (gated)] [ Postprint (open; pdf)]
  98. A comprehensive review of the literature on the cost-effectiveness of prevention and treatment interventions related to HIV prior to 2005. Includes a copious electronic table with details on all papers reviewed.

Book Chapters

  1. Harling G, Soderstrom L. The contribution of cost-effectiveness analysis. In: Beck EJ, Mays N, Whiteside A, Zuniga JM (Eds). The HIV Pandemic: local and global implications. Oxford: Oxford University Press. 2006.
    [Publisher (gated)]

Letters to the Editor

  1. Oldenburg CE, Bärnighausen T, Tanser F, Iwuji CC, De Gruttola V, Seage III GR, Mimiaga MJ, Mayer KH, Pillay D, Harling G. Reply to Cohen, et al. Clinical Infectious Diseases, 2016. 16(12): 1680.
    [Journal (open)]
  2. A response to Cohen et al.'s letter regarding the Oldenburg et al. paper on the real-world effect of ART within serodiscordant couples.

  3. Harling G, Tsai AC, Subramanian SV. Intimate partner violence and HIV: embracing complexity. Lancet Global Health, 2015; 3(6): e313.
    [Journal (open)]
  4. A letter questioning how a commentary on a recent analysis on intimate partner violence and HIV interpretted the published findings. Argues that the emerging picture from this literature is that some IPV-related risk factors seem not to put women at risk, but women facing multiple or extreme forms of IPV and controlling behaviour are more likely to be HIV-positive.

  5. Harling G, Subramanian SV. The perils of conducting meta-analyses of observational data
    Journal of the International AIDS Society, 2014; 17: 19112 [Journal (open)]
  6. A letter highlighting the potential to hide either confounding or effect-modification of relationships of interest when pooling aggregated data for the purposes of meta-analysis and systematic review. Written in the context of a recent meta-analysis for intimate partner violence and HIV

Reports and Manuals

  1. Manual for costing HIV facilities and services. Geneva: UNAIDS. 2011.
    [UNAIDS (pdf)]
  2. Workbook for the collection of cost information on HIV facilities and services. Geneva: UNAIDS. 2011.
    [UNAIDS (pdf)]

Working Papers

  1. Grimard F, Harling G. The Impact of Tuberculosis on Economic Growth. August 2004.
    [Working Paper (pdf)]

Theses and Disserations

  1. Harling G. Harvard School of Public Health. Socioeconomic status, socioeconomic context and sexually transmitted infections. May 2013. [ ScD dissertation]
  2. Harling G. University of Cape Town The social epidemiology of tuberculosis in South Africa: a multilevel analysis. December 2006.
    [ MPH thesis (pdf)]
  3. Harling G. McGill University. The impact of tuberculosis on economic growth. May 2003.
    [ MA thesis (pdf)]

Oral Presentations

  1. Harling G, Bountogo M, Sié A, Bärnighausen T, Lindstrom D. A new method for recording responses to questions about traumatic sexual life events: evidence of the use of the Non-Verbal Response Card method in a survey of adolescents in rural Burkina Faso. Population Association of America Conference, Austin, TX, April 2019.
    [ Handout of slides]    [ Working paper]
  2. Oldenburg C, Bor J, Tanser F, Harling G, Mutevedzi T, Shahmanesh M, Seage G, De Gruttola V, Mimiaga M, Mayer K, Pillay D, Bärnighausen T. Immediate HIV treatment prevents new infections: causal evidence on the real-world impact of immediate versus deferred ART in rural South Africa. 21st International AIDS Conference, Durban, July 2016.
    [ Slides]   [ Webcast of presentation]
  3. Harling G, Gomez-Olive FX, Morris K, Payne C, Perkins J, Bärnighausen T, Berkman L. Interviewer identity and learning effects as sources of variation in self-reported reported social networks. Sunbelt XXXVI 2016, Long Beach, CA, April 2016.
    [ Handout of slides]
  4. Harling G, Onnela J-P. Degree truncation and its impact on spreading process outcomes. Sunbelt XXXV 2015, Brighton, June 2015.
    [ Handout of slides]
  5. Harling G, Newell ML, Tanser F, Kawachi I, Subramanian SV, Bärnighausen T. Age-Disparate Relationships and HIV Incidence amongst Rural South Africa Women. Conference on Retroviruses and Opportunistic Infections (CROI), Boston, March 2014.
    [ Webcast of presentation]
  6. Harling G, Orrell C, Wood R. The Impact of Delaying Uptake of Second Line Therapy on the Cost-Effectiveness of Antiretroviral Treatment in South Africa. International AIDS Economics Network Meeting, Toronto, August 2006.
    [ Working Paper (pdf)]

Poster Presentations

  1. Harling G, Kobayashi L, Farrell MT, Wagner RG, Berkman L. Social engagement and cognitive health: a population-based study of older men and women in rural South Africa Population Association of America Conference, Austin, TX, April 2019.
    [ Poster (pdf)]
  2. Harling G, Moyo S, McGovern ME, Mabaso M, Marra G, Bärnighausen T, Rehle T. National South African HIV prevalence estimates robust despite substantial test non-participation: evidence from the 2012 national population-based survey. Abstract No. WEPEC164. 21st International AIDS Conference, Durban, July 2016.
    [ Poster (pdf)]
  3. Harling G, Tanser F, Mutevedzi T, Bärnighausen T. Assessing the validity of respondents’ reports of their partners’ ages in a rural South African population-based cohort. Population Association of America. San Diego, CA, April 2015.
    [ Poster (pdf)]
  4. Harling G, Wang R, Onnela J-P, De Gruttola V. Leveraging Contact Network Structure for Cluster Randomized Trial Design. Modeling the Spread and Control of Ebola in West Africa. Atlanta, GA, January 2015.
    [ Poster (pdf)]
  5. Harling G, Bärnighausen T. The interplay of own and partner's education on HIV risk in sub-Saharan Africa. Society for Epidemiological Research Annual Conference. Seattle, WA, June 2014.
    [ Poster (pdf)]
  6. Harling G, Bärnighausen T, Subramanian SV, Kawachi I. School Income Inequality and Sexually Transmitted Infections in the United States. Society for Epidemiological Research Annual Conference. Minneapolis, MN, June 2012.
    [ Poster (pdf)]
  7. Harling G, Orrell C, Wood R. Healthcare utilization by a cohort of late-stage HIV-positive patients commencing antiretroviral medication in South Africa. Abstract No. WEPE0085. XVI International AIDS Conference, Toronto, August 2006.
    [ Poster (pdf)]

Guy Harling's personal webpages. Last updated: